Diabetes mellitus is a systemic disease characterized by disorders in the metabolism of insulin, carbohydrates, fats and proteins, and in the structure and function of blood vessels. The primary symptom of acute diabetes is hyperglycemia, often accompanied by glucosuria, the presence in urine of large amounts of glucose, and polyuria, the excretion of large volumes of urine. Additional symptoms arise in chronic or long standing diabetes. These symptoms include degeneration of the walls of blood vessels. Although many different organs are affected by these vascular changes, the eyes and kidneys appear to be the most susceptible. As such, long-standing diabetes mellitus, even when treated with insulin, is a leading cause of blindness.
There are two recognized types of diabetes. Type I diabetes is of juvenile onset, ketosis-prone, develops early in life with much more severe symptoms and has a near-certain prospect of later vascular involvement. Control of this type of diabetes is difficult and requires exogenous insulin administration. Type II diabetes mellitus is of adult onset, ketosis-resistant, develops later in life, is milder and has a more gradual onset.
One of the most significant advancements in the history of medical science came in 1922 when Banting and Best demonstrated the therapeutic effects of insulin in diabetic humans. However, even today, a clear picture of the basic biochemical defects of the disease is not known, and diabetes is still a serious health problem. It is believed that two percent of the United States' population is afflicted with some form of diabetes.
The introduction of orally effective hypoglycemic agents was an important development in the treatment of hyperglycemia by lowering blood glucose levels. Oral hypoglycemic agents are normally used in the treatment of adult onset diabetes.
A variety of biguanide and sulfonylurea derivatives have been used clinically as hypoglycemic agents. However, the biguanides tend to cause lactic acidosis and the sulfonylureas, though having good hypoglycemic activity, require great care during use because they frequently cause serious hypoglycemia and are most effective over a period of ten years.
In Chemical & Pharmaceutical Bulletin, 30, 3563 (1982), Chemical & Pharmaceutical Bulletin, 30, 3580 (1982) and Chemical & Pharmaceutical Bulletin, 32, 2267 (1984), reference is made to a variety of thiazolidinediones which have blood glucose and lipid lowering activities. Antidiabetic activity of ciglitazone was also reported in Diabetes, 32, 804 (1983). However, these compounds have proven difficult to use because of insufficient activities and/or serious toxicity problems.
Furthermore, Alzheimer's disease, a degenerative disorder of the human brain, continues to afflict more and more persons throughout the world. Such disease results in progressive mental deterioration manifested by memory loss, confusion, disorientation and the concomitant loss of enjoyment of life associated therewith. At the present time there is no scientifically recognized treatment for Alzheimer's disease. Because of this, and because of the debilitating effects of the disease, there continues to exist an urgent need for effective treatments.
The present invention relates to a series of hypoglycemic agents which are capable of lowering blood glucose levels in mammals. Accordingly, one object of the present invention is to provide compounds having excellent hypoglycemic activity. The hypoglycemic agents of the present invention are believed to have minimal toxicological effects. It is, therefore, believed that the compounds of the present invention may be very useful for treating diabetes.
The present invention also relates to a series of compounds having cathepsin inhibitory activity. As will be discussed more fully below, compounds capable of inhibiting cathepsin (and, in particular, cathepsin D) may be useful for treating Alzheimer's disease. Accordingly, a further object of the present invention is to provide compounds which can be used to treat Alzheimer's disease.
Other objects, features and advantages of the present invention will become apparent from the subsequent description and the appended claims.